tv Sanjay Gupta MD CNN February 13, 2010 7:30am-8:00am EST
well, you know, the latest from afghanistan, that is coming up, the largest offensive in the war is happening right now. we're going to get you there, plus cnn saturday morning continues with much more. you don't want to miss that. but first, dr. sanjay gupta m.d. begins right now. i'm dr. sanjay gupta in port-au-prince, haiti. i'm here in port-au-prince the show about a month now after the earthquake. exactly what is happening here and not let the world forget, as well. going to the hospitals. so many patients received important life-saving care. but what's next? how do they recover? where do they recover? often times it's in tent cities like the one behind me and the uss comfort, it was called a ship of medical mercy to me. what exactly does it do? i'll sit down and talk to the chief of surgery aboard that ship. and people have said there's a ticking time bomb in these medical hospitals, as well. something that could potentially affect the entire world, what is it? i'll tell you. you're watching "sgmd."
you know, i was at many of the hospitals in port-au-prince right after the earthquake. if, in fact, you could call them hospitals. most of them weren't even still standing and they were certainly overwhelmed. so many injuries, so many life-threatening injuries, struggling to keep up. a month later, the entire dynamic of these hospitals have changed. the question is, how will they continue to keep up? and where do the patients go after they leave the hospital? is there enough resources for them in the tent cities like the one behind me? take a look. what you're looking at is a long line forming outside one of the largest public hospitals in port-au-prince. nearly four weeks after the earthquake and a couple things you'll notice right away. first of all, the majority of the patients here are not people injured in the earthquake. these are people who have chronic disease like diabetes and heart disease.
the other thing you'll notice is things are much more organized than they were a few weeks ago. compare that to just two weeks ago. here you see mainly quake survivo survivors, patients dramatically injured requiring am pewatio amputations. things have improved dramatically. you may be wondering what happens to so many of those patients? well, many of them end up here in what's tosupposed to be a temporary tent city. these are the conditions people are supposed to recover from major operations. back in the states, patients would be getting all sorts of different treatments, might still be in the hospital. they would be getting dressing changes. instead, they're forced to recover in conditions like this. it's dirty, a lack of medications, and a lack of food, as well. and there's something else that people are really worried about. it's rainy season, we saw our first rain in a month. and with rain comes all sorts of potential infectious diseases.
the world health organization says the incidence of measles goes up, tetanus, and diarrhea, as well. but take a look at this. rainy season is pretty tough here. imagine living in this. this is somebody's home in the middle of rainy season. instead they opt for structures like this to try and protect them. it's not to say that people aren't trying to help. mobile clinics are going out into these tent cities, trying to give vaccines in a country that has not seen nearly enough vaccines in the future. but this is it. people are trying to recover in a temporary tent city that i can tell you is increasingly becoming more permanent. there is still a lot of work to be done in many of the hospitals here in haiti. and i can tell you, no one knows that better than the special envoy bill clinton. he was discharged from the hospital after undergoing a stenting procedure. i can tell you he was here down in haiti a couple of weeks ago. i toured around with him. he was looking to be in good
spirits and good health. people asked me, did i notice anything that seemed amiss? and i wasn't looking for anything amiss with him, he seemed fine, not short of breath, not complaining of anything. he had his bypass operation back in 2004, that was the cardiac bypass operation and there was a lot of questions. how was he feeling after that? did the operation go well? i asked him those same questions less than a year ago. take a listen. >> are you back 100%? >> i think so. it's interesting. in some ways i'm stronger than i was before my surgery and by conventional measures i'm healthier. i've still got about 10 pounds to lose i gained on the campaign last year working for hillary. otherwise i'm fine. the one thing i've noticed is my balance is better when i'm doing balance drills. but the one thing i noticed that a friend of mine referred to as raw country strength, i don't know if i've recovered. i can't hit a golf ball as far even though i can lift more weights. >> now, when we're talking about
the stenting procedures specifically he had done this past week, not to trivialize it, but it is basic plumbing. look at it like this, blood vessels in the heart that aren't getting enough blood flow, they put these stents in to open up those blockages and allow more blood flow to the heart. we're told he'd been having chest discomfort over the last few days and ultimately concluding he needed to have the procedure done. took about an hour. and again, in the hospital just overnight. he is said to be in good spirits and the doctors say his prognosis is excellent. my guess is we may see him back here in haiti even over the next couple of months and probably traveling around it had world like he is so famous for. a lot of questions do remain about haiti. one of the biggest ones we get is what about the water? even before the earthquake, about half the population here had access to clean water. what is it now? how is it going to change? it can happen anytime,
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every week around this time, we try to answer some of your questions. well, we've been getting a lot of questions, specifically about haiti. edwa edwardo in california asked some important questions, and that is about the water. he says that bottled water and portable treatment facilities are okay for now, but what is the status of the water infrastructure in port-au-prince at this moment? that's a great question, edua o eduardo. there's a significant percentage of the population here in haiti that did not have access to clean water even before the earthquake. but we did check in with our colleagues over at unicef to try to figure out what they're saying specifically about this. and they're saying that they believe that the current system here is functional. urban sources of water do seem to be working at this time. the big issue has really been distribution. how do you get water that is clean, how do you get water that is safe distributed to people in places like the tent city behind me or all over the country that really need the water? there is a water corporation
down here called nipa and it's been assessing their plans and according to the un has already begun some repairs. they do believe the current system is going to need to be in place for three months. but there are plans in place to try to figure out how to best assess the needs of clean water around the country and how to meet them in the months and years to come after that. really important topic, obviously. we want to shift topics now to something else that we talk a lot about here on the program. and it has to do with childhood obesity. we now know that the white house is starting to take this on and that the first lady is going to spearhead a campaign called let's move. she spoke pretty candidly about this with our own larry king. take a listen to what she had to say. >> one thing i try to emphasize is that this isn't about weight and it's not about looks. it's not -- it's not a physical issue. it's really about the quality of life of our kids. because, you know, teachers are seeing the challenges that kids
with weight issues are having. not being able to participate in gym, feeling a little more sluggish. this is a quality of life issue. and it's not about weight and diet, it's about fitness and it's about overall nutrition that we really have to be emphasizing here. >> first lady even spoke about how her children's pediatricians pointed out warning signs in their own children when they were on the campaign trail about some of the decisions they were making and some of the decisions they needed to make to reverse some of the trends. so really comes down to some basic advice. a healthy living, making very smart food choices, making sure to get exercise, and ensuring that all of those things start at a very young age. we'll certainly be keeping on of that with our own fit nation program and touring around the nation talking about these same issues. here in haiti as we've been talking about, one of the big
resources for so many patients is a medical ship of mercy. it's called the uss comfort. and we had a chance to sit down and talk to the chief of surgery on that ship and what he's seeing and what he thinks he'll be seeing in the months to come. wow, is this... fiber one honey clusters? yes. it's delicious. delicious. i know. but it can't have... can't have about half a i assure you it does. i was expecting... expecting sawdust and cardboard? i know. i can only taste... only taste the crunchy clusters, honey, and brown sugar. no madam, i don't have esp. ok. i'll take a box, but you probably already knew that. (announcer) fiber one. cardboard no. delicious yes. i switched to a complete multivitamin with more. only one a day men's 50+ advantage...
welcome back to the program. i'm dr. sanjay gupta. in haiti, we're now on the uss comfort. a ship that a lot of people have been talking about for some time especially with respect to what's happening here in haiti. you can see where we are, haiti behind me. and with me is commander tim donahue, the director of surgery here on the ship. thanks for being on the show.
>> thank you, welcome. >> you guys have been very busy. give me a little bit of an idea how long you've been here and how busy you've been. >> well, we took off from baltimore on the 16th of january, arrived here on the evening of the 19th and received our first patient. we were about 150 miles away from haiti when they starteding patients in. the first day we took about 100 patients and subsequent days. by our fourth day here we had over 320 patients here on the ship. all of whom were critical casualties. >> did you feel like you were able to keep up? we kept hearing that the comfort was overloaded, you know, it was impossible to get on. what was happening? >> well, to get on to the ship, you have to fly by helicopter. and we had helicopters arriving about every six minutes during daylight hours and we were even taking them at night. you can get about three patients at a time on the ship. they were coming downstairs at a pretty quick pace. we had enough folks down in casual receiving, but everybody
needed to go to the operating room and triageing those folks was the challenge downstairs. and we were running the operating rooms 24/7 up until about four days ago. >> this is obviously a huge ship known for its medical capabilities. is there anything you guys can't do on the ship. sounds like just about everything. >> well, from a surgical standpoint, we can do everything but a transplant and open heart surgery in terms of bypass. but we've got all of the surgical specialties covered. everything from neuro surgery to oral surgery, neurology, we've even done eight deliveries on the ship and had nine babies, one set of twins. >> when this all happened, you obviously heard about the earthquake, where were you? and how did you find out you were coming here? >> well, i found out -- i was being cliniced and i got an e-mail saying we're activated, we're going to be going, i need you to come out. that was on a wednesday, and
friday afternoon, everybody who was leaving was on the ship. we took off first thing that saturday morning. >> the earthquake was on tuesday, and by saturday you guys were on your way here? >> yes, sir. >> what goes through your mind when you're here? do you have a family? how do you coordinate everything? >> i've thankfully my wife's used to this. identify been out on three other missions on the ship. in fact, we just got back in august from a deployment down here. getting underway for haiti was interesting because not quite a year ago we were here in this same spot doing a humanitarian mission. and the number of folks that came back out with me here were incredible. we had folks who knew doctors on the ground, folks from the ministry of health, the general hospital there. we already had connections with ngos, we were e-mailing back and forth. >> you have patients on this ship such as patients with spinal cord injuries, patients with brain injuries, kids. it would be impossible for them to go back to haiti and live there.
the resources aren't there. on the other hand, they're not necessarily in the life threatening condition. what happens to those patients? >> that's a great question. right now we've got about 15 people with spinal cord injuries. and we have another six who have incomplete spinal cord injuries. we're trying to find the best place to take care of them. they've gone through the initial trauma of the quake, gone through surgeries to sort of repair those final fractures they've had, and now we're trying to get them to a rehabilitative center. there's nothing in haiti at the moment that can take on these patients. we're working through our ngo partners to see what they can bring to bear. we're trying to work with some of our colleagues back in the states. >> you guys are probably going to be here several months if not longer. >> that's the big question. you know, haiti needs a big hospital that can help take care
of these folks. whether we're that hospital or something can be set up ashore, i don't know. we're here as long as they need us and as long as the president tells us we need to be here. >> good to meet you. director of surgery dr. tim donahue, you do amazing work. and hopefully we'll come back and visit you. >> thank you. plus liquid gels rush relief everywhere you need it. it's the most complete relief you can get in a liquid gel, so you feel better, fast. alka-seltzer plus liquid gels. speaking of, what's on friday's menu? friday is fish day. well, maybe it should be tuna helper day. mmmm... fish delish, yes? i'll take it. sold! tuna helper. one tasty meal.
welcome back to "sgmd." we're here in port-au-prince, haiti. these tent cities have been up almost since earthquake happened, more than a month ago now. if you talk to health experts on the ground here they'll say there are some real concerns about infections. exactly what types of infections and how bad could it become is a question we had as well. we really zeroed in on an
infection tuberculosis which could impact haiti and could potentially have an impact all over the world. here's why. there is something happening here in these blue tents behind me. what's happening inside there could impact people all over the world. think of this as a quarantine tent. people in here have been quarantined since the quake. many of them have tuberculosis, which is why we're going to wear a mask. you will notice the doors are open. if you stay ten feet away, it will be okay. the sunlight kills the bacteria as well. once you go inside, you have to wear a mask like this. let's go meet some of the patients. this is cindy. she's 20 years old. we've spoken to her already. take a look at her. she's obviously had a lot of difficulty since the quake. she lost her home. she also lost her medications, which puts her at high risk of developing tuberculosis.
how are you feeling? there's a lot of things doctors pay attention to. syndia has some sweating. it's hot outside but it's more than that. also the sweats occur at night. her lips are chapped as well. you can see, just from the dehydration. hard to tell but she's breathing quick quickly. has difficulty breathing. tuberculosis is a disease of the lungs. what brought her in here is this dramatic loss of weight. look at her arms. she's lost so much weight. malnutrition, difficulty eating. a lot of these patients including syndia say that she lost her home and medication. she couldn't take her medications for a period of time. what's the risk there? >> two big risks. one, of course, we worry about the most is developing multi-drug resistance. she might be taking om one med that's working for t.b. and she might then develop resistance to all the other meds. and then she might be more
infectious. the tb can grow back. most of the patients here are living in tent cities where they're sleeping nose to nose with their families, with hundreds of thousands other people sleeping nose to nose with them. it's a chance of just spreading it and spreading it. >> people think of haiti as over there, someplace else, not here. london, new york, atlanta, san francisco, do people need to be worried about what's happening in this tent? >> over time this is going to grow and grow. if we allow tb to grow in haiti, people are going to travel, people are going to be infected, even workers like us here. and that can really spread to miami, new york city, and eventually to san francisco and southeast. and we really do not wish to have multi-drug resistance. it's something even the u.s. can't treat well. it would be terrible if we had that spread. >> where will you go after you leave here? >> she doesn't know.
she doesn't have a house to go to. >> what happens to someone like syndia? is from a medical standpoint going to be okay? >> i hope so. if the right infrastructure is in place. she has totally treatable diseases in the u.s. right now i know i can treat all of her diseases. >> i tell you, it's tough to watch, to hear what syndi a's life is like and what it might be like. it's a theme that comes up over and over again that people are getting good care now here in haiti, but you know, people cannot forget that that need is going to be ongoing for a long time. people like syndia, there's so many like her, she doesn't have a home to go to shp she needs her medications and a lot of follow-up. haiti has one of the largest concentrations of tuberculosis in the americas even before the earthquake. and tuberculosis is a disease that kills 5,000 people a day around the world. so very important to keep a
focus on this. people who lose their medications can not take their medications, can develop drug resistance tuberculosis. and that can spread all over the world. again, this is something we really, really need to pay attention to. we are staying here in haiti. you know, one of the things that really strikes me is what happens to patients after acute life-saving operations. i had a chance to perform an operation aboard the uss carl vincent. a 12-year-old girl. what i was most interested in, though she's done well from her operation, what is her life going to be like now. i'll have some final thoughts. stay with the program. eat. i want to personally thank you for 100 calorie hearty chicken rotini. well, it's not just me. you're so funny. i like you. [ male announcer ] progresso. you gotta taste this soup. but my doctor told me that most calcium supplements... aren't absorbed properly unless taken with food. he recommended citracal. it's different -- it's calcium citrate, so it can be absorbed with or without food. citracal.
so many times over this past month i have had my faith completely trashed, as i saw unjustified loss of life and suffering. i saw amputations being performed without adequate anesthesia, as nurses and doctors held down a patient while performing brutal operations. i saw the tears running down those same nurses and doctors' cheeks while their faces were still with desperation, determination, and little anger at the awful position they were all in together.
but i also had moments where my faith was restored. small improvements in water distribution, a slow trickle of supplies turning into a river of good will and a rush of health care providers and private citizens with sleeves rolled i and grit on their skin. like my wife, they all wanted to help, in any way possible. if you look throughout the history of our own lives, there are a few occasions where we see something that galvanizes the entire world, in a world where there's too much bingering about politics and too much fascination with pop culture. reve every now and then people simply come together. i returned to haiti because i wanted to see the recovery happening here. people shouldn't forget what has happened, what's going to be necessary for a long time to come. i returned to haiti because i wanted to remind people of the relentless and extraordinary resolve of the beautiful haitian people. i came back because the story i'm telling is of the scales of faith being tipped here just a
little bit. i can tell you some of the things we've seen down here in haiti, they have been faith challenging in so many ways. but things are getting better. it is safe to say that a lot of work still needs to be done. i think that's something you have heard over and over again in today's show. one of the people we got to know down here in haiti, is a young girl, kimberly, 12 years old. i got to know her personally because the united states military asked me to fly on her carrier and perform a brain operation on her because she had a terrible brain injury. very worried about her, but delighted to report that she is doing well. you're looking at images of her now. we have reunited her with her father which was very heartwarmi heartwarming, a father's love for his daughter was really obvious will one of the things i wanted to leave you with is what you're looking at is going to be her life now. she's going to recover in this setting underneath this tarp. tough for anybody to recover here but really emblem attic of